Epidemiology & Biostatisticshttp://hdl.handle.net/1903/71252016-11-20T10:34:19Z2016-11-20T10:34:19ZExamining the Association between Acculturation and Hypertension among Asian Americans in the Washington D.C. Metropolitan AreaSim, Hwahttp://hdl.handle.net/1903/184332016-06-23T02:40:33Z2016-01-01T00:00:00ZExamining the Association between Acculturation and Hypertension among Asian Americans in the Washington D.C. Metropolitan Area
Sim, Hwa
Objective: To evaluate the association between Acculturation and hypertension among Asian Americans in the Washington, D.C. metropolitan area.
Methods: A cross-sectional study was conducted of 600 Chinese, Korean, and Vietnamese adults. Logistic regression was used to investigate the relationship between acculturation variables (years in the U.S., self-rated acculturation, self-rated English fluency) and hypertension, determined from a mean of 3 blood pressure readings taken on site.
Results: Compared to those who resided in the U.S. for 0-5 years, individuals who resided for 6-10 years were about 60% less likely to have hypertension (aOR= 0.36; 95% CI: 0.12, 1.05; p-value=0.06). No significant association was observed between self-rated identity and hypertension. Compared to those with poor English fluency, those who speak “so-so” English have increased odds of hypertension (aOR=1.57; 95%CI: 0.93, 2.64; p-value= 0.09). Disaggregated analysis was conducted for Asian American subgroups, which showed differences in trends of acculturation and hypertension. Conclusion: Findings suggest an association between acculturation and hypertension, guiding future studies to investigate further into these observed effects. Some subgroup differences were observed among Asian American subgroups, potentially suggesting a subgroup-focused intervention.
2016-01-01T00:00:00ZThe relationship of early social, mental, and behavioral experiences with adult obesity and Alcohol Use DisorderO'Neill, Allison Hunthttp://hdl.handle.net/1903/183262016-06-23T02:38:17Z2016-01-01T00:00:00ZThe relationship of early social, mental, and behavioral experiences with adult obesity and Alcohol Use Disorder
O'Neill, Allison Hunt
Stressful life events early in life, including symptoms of mental disorders or childhood maltreatment, may increase risk for worse mental and physical health outcomes in adulthood. The purpose of this dissertation was to examine the effects of childhood Attention Deficit Hyperactivity Disorder (ADHD) symptoms and maltreatment experience on two adult outcomes: obesity and alcohol use disorder (AUD). Mediational effects of adolescent characteristics were explored. This dissertation used Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health.
In Paper 1 (Chapter 3), we investigated the association between multiple types of child maltreatment and adult objective (body mass index; BMI) and subjective (self-rated) obesity, as well as mediating effects by adolescent characteristics including depressive symptoms and BMI. Results showed that after adjusting for sex, race/ethnicity, and maternal education, physical maltreatment was moderately associated with adulthood obesity as measured by BMI and self-reported obesity, while sexual maltreatment was more strongly associated with the objective measure but not the subjective measure. The indirect effects of mediation of adolescent BMI and depressive symptoms were statistically significant.
In Paper 2 (Chapter 4), the objective was to examine mediation by adolescent depressive symptoms, alcohol consumption, peer alcohol consumption, and delinquency in the relationship between ADHD symptoms and adult AUD. The indirect effects of mediation of adolescent delinquency, alcohol consumption, and peer alcohol consumption were statistically significant in single and multiple mediator models.
In Paper 3 (Chapter 5), the objective was to assess the joint effects of maltreatment/neglect on adult AUD. After adjusting for sex, race/ethnicity, child maltreatment, and parental AUD, ADHD symptoms were significantly associated with increased odds of AUD. There was no strong evidence of multiplicative interaction by maltreatment. This association was stronger for males than females, although the interaction term was not statistically significant.
This dissertation adds to the literature by examining relationships between several major public health problems: ADHD symptoms, childhood maltreatment, AUD, depressive symptoms, and obesity. This project has implications for understanding how early life stress increases risk for later physical and mental health problems, and identifying potential intervention targets for adolescents.
2016-01-01T00:00:00ZASSOCIATION OF SERUM VITAMIN D AND KEY CO-NUTRIENTS IN RELATION TO HYPERTENSION: A CROSS-SECTIONAL STUDY BASED ON NHANES DATABarainca, Pamelahttp://hdl.handle.net/1903/181902016-06-23T02:43:18Z2016-01-01T00:00:00ZASSOCIATION OF SERUM VITAMIN D AND KEY CO-NUTRIENTS IN RELATION TO HYPERTENSION: A CROSS-SECTIONAL STUDY BASED ON NHANES DATA
Barainca, Pamela
Observational studies demonstrate strong associations between deficient serum vitamin D (25(OH)D) levels and cardiovascular disease. To further examine the association between vitamin D and hypertension (HTN), data from the 2003-2006 National Health and Nutrition Examination Survey were analyzed to assess whether the association between vitamin D and HTN varies by sufficiency of key co-nutrients necessary for metabolic vitamin D reactions to occur. Logistic regression results demonstrate independent effect modification by calcium, magnesium, and vitamin A on the association between vitamin D and HTN. Among non-pregnant adults with adequate renal function, those with low levels of calcium, magnesium, and vitamin D levels had 1.75 times the odds of HTN compared to those with sufficient vitamin D levels (p = <0.0001). Additionally, participants with low levels of calcium, magnesium, vitamin A, and vitamin D had 5.43 times the odds of HTN compared to those with vitamin D sufficiency (p = 0.0103).
2016-01-01T00:00:00ZRACIAL/ETHNIC VARIABILITY IN THE EFFECT OF RADIATION ON SECOND PRIMARY THYROID CANCER IN CHILDREN: ANALYSIS USING SURVEILLANCE EPIDEMIOLOGY AND END RESULTS DATAMcClarin, Lavisha J.http://hdl.handle.net/1903/181532016-06-23T02:39:46Z2015-01-01T00:00:00ZRACIAL/ETHNIC VARIABILITY IN THE EFFECT OF RADIATION ON SECOND PRIMARY THYROID CANCER IN CHILDREN: ANALYSIS USING SURVEILLANCE EPIDEMIOLOGY AND END RESULTS DATA
McClarin, Lavisha J.
Increases in pediatric thyroid cancer incidence could be partly due to previous clinical intervention. This retrospective cohort study used 1973-2012 data from the Surveillance Epidemiology and End Results program to assess the association between previous radiation therapy exposure in development of second primary thyroid cancer (SPTC) among 0-19-year-old children. Statistical analysis included the calculation of summary statistics and univariable and multivariable logistic regression analysis. Relative to no previous radiation therapy exposure, cases exposed to radiation had 2.46 times the odds of developing SPTC (95% CI: 1.39-4.34). After adjustment for sex and age at diagnosis, Hispanic children who received radiation therapy for a first primary malignancy had 3.51 times the odds of developing SPTC compared to Hispanic children who had not received radiation therapy, [AOR=3.51, 99% CI: 0.69-17.70, p=0.04]. These findings support the development of age-specific guidelines for the use of radiation based interventions among children with and without cancer.
2015-01-01T00:00:00Z